White-coat syndrome?

I am new to the FDMB, but my cat Motska has been diabetic for the past year-and-a-half. My vet has rather discouraged me from doing home testing -- partially because he says it is stressful for the cat, and he didn't think it would help things much since I can just bring her in for tesing (at $25 each time), but also because we weren't sure I could do it. (I have a tendency to faint at the sight of needles and blood -- the first time I did her insulin at the vet's office, I came very close to passing out.)

So I haven't been testing at home, but I really think I need to. When I take her to the vet to check her fasting bg, it's usually somewhere in the 300's, so each time, he has suggested increasing her Vetsulin by 1/2 unit (yes - we do know about the halt in production -- we're currently debating what to do next with the insulin). We had her up to 3.5 units, and 5 days later she appeared to go hypo (lethargy and facial "ticks"). I was prepared, and she came around, and we (vet & I) dropped her to 2 units for a while. After weekly testing at the vet (always in the 300's), she gradually went back up to 3 units of Vetsulin. 4 days later she went hypo again. So we started over at 2 units and now have her at 2.5 units.

I asked the vet about the possibilty that her "white-coat syndrome" is giving us a bg reading that is WAY off from how she truly is at home and that we may be overdosing her insulin because of it. He stated that it would only throw off her bg reading by maybe 20-40 points, because she's used to the vet visits by now. I'm not so sure.

So my questions are: how much can white-coat syndrome throw off a cat's bg readings? 40 points? 100 points? 200 points?
And can it last through a whole weekend -- I kennel Motska at the vet's office, and don't want them to increase her dosage if it's just temporarily stress-related (ex: over a 4-day weekend)?

Thanks in advance for all of your help! I just wish I had gotten on the FDMB a year-and-a-half ago!!

Kris

 

It can throw it off 100 points or more, depending on how stressed the cat gets.

Testing at the vet not only is unproductive and useless information, it's a huge waste of your money. As you are only getting one reading without any real information to back it up.

We encourage home testing because you will be able to get a better history of the bg's and how the insulin is working or not working in the cat. You will also know if there is a potential problem - hypo situation and be able to handle it quickly and effectively.

Not home testing, you are literally shooting a drug into a cat blindly. Think about it like this - if it were you or a human family member that was diabetic - would you ever shoot insulin without knowing what the bg's are? NO human doctor would ever advise you to do this.

Why is it any different for a cat?

And I'm sorry, you are going to need to not fear the site of a little blood, as you need to get blood in order to test the bg.

 

Veterinary journal articles linked in the feline diabetes faq say that vet stress can skew results sufficiently that it is much more valid to test at home. Vet stress CAN raise by 100 points or even more, but not with all cats.

I was unwilling to test, my vet was unwilling to support it and we didn't do it at first. But it just didn't work to use fructosamines and attempted vet curves, and if you look at it from a human perspective, NOT testing at home makes no sense!

For the first bit, testing at home is a bit daunting but honestly, it usually becomes very easy. It doesn't hurt the cat and is easier than injecting if you are faint at heart.

Consider getting someone near you to show you, sooner rather than later. It is absolutely by far the best tool you can have and cuts out the guesswork and risk!

 

I don't know the exact number but it would be higher than 20-40 points. There's a car ride involved too, that's stressful for most cats. Waiting room, weird smells, dogs, people, carrier.

I once worked with a woman that could not get her blood pressure taken because she would get so worked up about it, even trying it at stores that have blood pressure cuffs to try out, she would work herself up too much and she's human and could try to talk herself down. Imagine our cats going to a place where there's always a poke or prod.

I assume you've gotten used to shots by now? Do you think you could manage a hometest? I fainted once when my husband was getting stitches on his head a few years ago so I completely understand, however the amount of blood needed to test my cats is smaller than this "o" I just typed. Could you handle that amount of blood?

You'd be doing a lot to help your cat and yourself, you'd see how your cat truly reacts to insulin, determine if the type of insulin your using is really helping your cat and you'd always know when it was safe to give insulin and lastly, you'd know when your insulin was starting to go bad or lose effectiveness.

 

Thank you for your help! I already had it on my grocery list to pick up the supplies at Wal-Mart today. I've gotten used to giving her insulin -- it helps that Motska is usually so relaxed when I do it (problem is that sometimes she's so relaxed that she tries to roll over and stretch while I have the needle in her)! So now I feel comfortable that I'll be able to do the home testing.

I think the problem is that I just went along with what the vet was telling me, and didn't do that much research on my own. I think we forget sometimes that vets have more information to keep up with than our regular doctors do. They only have to know about medical issues for people. And we just expect vets to know everything there is to know about cats, dogs, fish, lizards, turtles, horses, ferrets, etc..... Thanks for the advice -- now I have a bit more information on issue of stress-induced hyperglycemia for the next time we go for a visit. (And I look forward to not having to spend so much on frequent vet visits!)

 

I'm late to this question, but the Animal Medical Center in NYC routinely deducts 100 points from in-clinic b/g readings to account for vet stress.

 

Mandy and Snickers vet has me home test them because if she tries to test in the offie they refuse to eat ,Mandy hides in a corner and is stiff,Snickers yells at the top of his lungs and banges on the age. They can have swings that range from 36-600+. So She has me do it at home and the results are amazing. I would run curves at home and share with vet because the cresults will be more acurate and not have a wide swing.